There is a need for awareness about subclinical atherosclerosis in patients with diabetes and the effects of coronary artery calcium (CAC) in subpopulations of patients. This according to a recent study that examined the association of cardiovascular disease risk factors with, and their cumulative effect on, CAC in hard-to-reach asymptomatic patients with diabetes. A total of 2,563 community-dwelling asymptomatic subjects from Central Appalachia participated in CAC screening at a heart center. Researchers found:

In total, 55.8% and 13.7% of study participants had subclinical atherosclerosis (CAC ≥1) and diabetes, respectively.

The presence of CAC was higher in subjects with diabetes (68.5%) than those without (53.8%).

Compared to subjects without diabetes with CAC=0, obesity, hypertension, hypercholesterolemia, and smoking increased the odds of the presence of CAC (CAC score ≥1) regardless of diabetes status; however, with larger odds ratios in subjects with diabetes.

Compared to subjects without diabetes with CAC score=0, having 3, 4, and ≥5 risk factors increased the odds of presence of CAC in subjects with diabetes by 14.06, 32.30, and 47.12 times, respectively.